diabetestalk.net

Can Ketoacidosis Cause Kidney Failure

Outcome Of Acute Renal Failure In Children With Diabetic Keto Acidosis (dka)

Outcome Of Acute Renal Failure In Children With Diabetic Keto Acidosis (dka)

OUTCOME OF ACUTE RENAL FAILURE IN CHILDREN WITH DIABETIC KETO ACIDOSIS (DKA) Poovazhagi V, Prabha Senguttuvan, Padmaraj R Diabetic Clinic, Institute of Child Health and Hospital for Children, Chennai Address for Correspondence Dr V Poovazhagi, 8/11 Manjolai Street, Kalaimagal Nagar, Ekkaduthangal, Chennai. 600 032, India. Email [email protected] Abstract The presentation and outcome of acute renal failure in children with diabetic ketoacidosis (DKA) were analyzed. Of the 130 DKA episodes treated at the Pediatric Intensive Care Unit (PICU), 15 children (11.5%) had renal failure. Sepsis and shock were the common etiological factors. Mortality in ARF complicating DKA was 40%. Persistent acidosis requiring bicarbonate therapy, reduction in intravenous fluid volume, reduced dose of insulin and peritoneal dialysis were the modifications in the treatment for this life-threatening complication. Keywords Acute Renal failure, DKA, infections, shock Introduction Cerebral edema is a life threatening complication of diabetic ketoacidosis (DKA), other complications include dyselectrolytemia, acute respiratory distress syndrome (ARDS), pulmonary edema and renal failure. Chronic renal failure due to diabetic nephropathy and its presentation with DKA is encountered in adults. But children with new onset diabetes mellitus (DM) or known diabetic children presenting with acute renal failure (ARF) is rare. Literature reveals few case reports of DKA with renal failure. (1,2,3) Reported mortality in ARF complicating DKA is about 50%. (1) We are presenting a series of children with DKA and renal failure. Methods & Materials This retrospective study was undertaken to evaluate the outcome of children with ARF in DKA from January 2006 to August 2010 in 130 children who presented with DKA. None w Continue reading >>

What Are The Causes Of Kidney Failures?

What Are The Causes Of Kidney Failures?

I had been suffering from kidney issues for several years… It also influenced my glucose levels and in general I felt really awful. I took a large daily dose of drugs in order to create my kidneys work correctly but they kept failing… Till a Fantastic friend recommended me a simple and low cost online tutorial, which certainly altered my life - click here to check it out Basically it’s a step-by-step treatment tutorial which helps improve your kidneys naturally, without the use of unnatural man-made pharmaceutical medications. Better yet, when you observe the program you are going to be able to postpone dialysis by years or even years … or perhaps even prevent dialysis all together! Just what is kidney failing? Your kidneys are a set of organs situated toward your lower back. Your kidneys send out contaminants to your bladder. Kidney failing occurs when your kidneys shed the capability to filter waste from your blood adequately. Several elements could disrupt your kidney health and wellness and feature, such as: toxic exposure to toxic wastes or specific medications specific severe and persistent conditions extreme dehydration kidney trauma Your body becomes overloaded with toxic substances if your kidneys can not do their regular task. If it’s left untreated, this can lead to kidney failing and also even be lethal. SIGNS AND SYMPTOMS Just what are the symptoms of kidney failure? Lots of different symptoms could take place throughout kidney failing. Generally someone with kidney failure will have a couple of symptoms of the disease, though often none are present. Possible signs include: a lowered quantity of urine swelling of your legs, ankles, as well as feet from retention of fluids brought on by the failure of your kidneys to get rid of water waste unexplai Continue reading >>

Diabetic Ketoacidosis In Chronic Kidney Disease Masquerading As Acute Pancreatitis

Diabetic Ketoacidosis In Chronic Kidney Disease Masquerading As Acute Pancreatitis

Robin George Manappallil Department of Medicine, Mar Baselios Medical Mission Hospital, Kothamangalam, Ernakulam, Kerala, India. Abstract Diabetic ketoacidosis (DKA) is a life threatening acute complication of type 1 diabetes. Since diabetic patients may have hypertriglyceridemia, they are at risk of developing acute pancreatitis (AP). Hyperamylasemia may suggest a diagnosis of AP, but levels may be elevated in DKA. Hence, serum lipase levels correlate better with the diagnosis of AP. However, pancreatic enzymes are excreted by the kidneys and their levels are elevated in patients with chronic kidney disease (CKD). This report describes a patient with type 1 diabetes and CKD stage 4, not on hemodialysis, who presented with DKA and had very high levels of pancreatic enzymes in the absence of pancreatitis. Keywords : Diabetes Ketoacidosis, Kidney, Renal Insufficiency, Pancreatitis, Hypertriglyceridemia. Introduction Acute pancreatitis (AP) is an acute inflammatory disorder of the pancreas. In 10-15% cases, the condition is life threatening. Epigastric pain is the predominant symptom, which may radiate to the back, chest, flanks or lower abdomen. Serum amylase and lipase levels are elevated in AP. Abdominal contrast enhanced computed tomography (CT), abdominal ultrasound, magnetic resonance imaging (MRI) are radiological methods which aid in diagnosis of AP [1]. However, elevated pancreatic enzyme levels have been noted in CKD patients [2,3]. Features like epigastric pain and elevated pancreatic enzymes are also seen in DKA [4]. Moreover, AP can present or coexist with DKA [5,6]. This case report aims to highlight the importance of elevated pancreatic enzymes in DKA and CKD, and the diagnostic dilemma posed by such elevations in patients with these two illnesses. Case Repo Continue reading >>

Diabetic Ketoacidosis In Chronic Kidney Disease Masquerading As Acute Pancreatitis

Diabetic Ketoacidosis In Chronic Kidney Disease Masquerading As Acute Pancreatitis

Abstract Diabetic ketoacidosis (DKA) is a life threatening acute complication of type 1 diabetes. Since diabetic patients may have hypertriglyceridemia, they are at risk of developing acute pancreatitis (AP). Hyperamylasemia may suggest a diagnosis of AP, but levels may be elevated in DKA. Hence, serum lipase levels correlate better with the diagnosis of AP. However, pancreatic enzymes are excreted by the kidneys and their levels are elevated in patients with chronic kidney disease (CKD). This report describes a patient with type 1 diabetes and CKD stage 4, not on hemodialysis, who presented with DKA and had very high levels of pancreatic enzymes in the absence of pancreatitis. Discover the world's research 14+ million members 100+ million publications 700k+ research projects Join for free Diabetic ketoacidosis (DKA) is a life threatening acute complication of type 1 diabetes. Since diabetic patients may suggest a diagnosis of AP, but levels may be elevated in DKA. Hence, serum lipase levels correlate better with the diagnosis of AP. However, pancreatic enzymes are excreted by the kidneys and their levels are elevated in patients with chronic kidney disease (CKD). This report describes a patient with type 1 diabetes and CKD stage 4, not on hemodialysis, who presented with DKA and had very high levels of Acute pancreatitis (AP) is an acute inammatory a progressive decline in glomerular ltration deciency, thereby releasing free fatty acid Continue reading >>

What Causes Kidney Failure? How Can It Be Cured?

What Causes Kidney Failure? How Can It Be Cured?

Diabetes and high blood pressure are two major causes of kidney failure disease. Diabetes is very deadly if not caught in early stages of kidney problem. Kidneys play a big role to functions of human body. When kidney is fail and builds wasters in your body then your blood pressure is rise and your body may retain excess fluid. There are so many reasons of kidney failure and possible symptoms i.e. · Swelling of your legs, ankles · Breath shortness · High blood pressure · Fatigue · Loss of appetite · Weakness of muscles · Abnormal urine output · Nausea - vomiting How to diagnosed kidney disease problem by Ayurveda Many research about of kidney failure and they have proved Ayurvedic kidney treatment is very effective for kidney disease and controlling of urea by Ayurveda. Continue reading >>

Diabetic Ketoacidosis

Diabetic Ketoacidosis

As fat is broken down, acids called ketones build up in the blood and urine. In high levels, ketones are poisonous. This condition is known as ketoacidosis. Diabetic ketoacidosis (DKA) is sometimes the first sign of type 1 diabetes in people who have not yet been diagnosed. It can also occur in someone who has already been diagnosed with type 1 diabetes. Infection, injury, a serious illness, missing doses of insulin shots, or surgery can lead to DKA in people with type 1 diabetes. People with type 2 diabetes can also develop DKA, but it is less common. It is usually triggered by uncontrolled blood sugar, missing doses of medicines, or a severe illness. Continue reading >>

How Can I Avoid A Kidney Failure? What Are The Causes Of Kidney Related Problems?

How Can I Avoid A Kidney Failure? What Are The Causes Of Kidney Related Problems?

I had been suffering from kidney issues for several years… It also influenced my sugar levels and in general I felt really bad. I took a large daily dose of medication to Be Able to make my kidneys work correctly but they kept failing… Till a Fantastic friend recommended me a simple and low cost online tutorial, which certainly altered my life - click here to test it out Fundamentally it is a step-by-step treatment tutorial which helps enhance your own kidneys naturally, without using unnatural man-made pharmaceutical medications. Even better, when you observe the program you will have the ability to postpone dialysis by years or even years … or perhaps even prevent dialysis all together! What is kidney failing? Your kidneys are a pair of organs situated towards your lower back. Your kidneys send toxins to your bladder. Kidney failing happens when your kidneys shed the capability to filter waste from your blood sufficiently. Lots of aspects can hinder your kidney health as well as feature, such as: harmful exposure to environmental pollutants or particular medications certain acute and also chronic illness severe dehydration kidney injury If your kidneys cannot do their regular work, your body comes to be overloaded with contaminants. This could bring about kidney failing or even be lethal if it’s left untreated. SIGNS AND SYMPTOMS What are the symptoms of kidney failing? Various signs and symptoms can happen during kidney failing. Generally a person with kidney failure will certainly have a few signs of the illness, though occasionally none exist. Feasible symptoms consist of: a reduced quantity of pee swelling of your legs, ankle joints, and feet from retention of fluids triggered by the failing of your kidneys to get rid of water waste inexplicable shortness Continue reading >>

Diabetes And Kidney Failure (stage 5)

Diabetes And Kidney Failure (stage 5)

What is diabetes? Diabetes happens when your body does not make enough insulin or cannot use insulin properly. Insulin is a hormone. It controls how much sugar is in your blood. A high level of sugar in your blood can cause damage to the very small blood vessels in your kidneys. Over time, this can lead to kidney disease and kidney failure. What is kidney failure? Healthy kidneys do many important jobs. They filter your blood, keep fluids in balance, and make hormones that help your body control blood pressure, have healthy bones, and make red blood cells. If you have kidney failure, it means your kidneys have stopped working well enough to do these important jobs and keep you alive. As a result: Harmful wastes build up in your body Your blood pressure may rise Your body may hold too much fluid Your body cannot make enough red blood cells When this happens, you need treatment to replace the work of your failed kidneys. There is no cure for kidney failure. A person with kidney failure needs treatment to live. Three types of treatment can be used if your kidneys have failed: Hemodialysis Peritoneal dialysis Kidney transplantation Your healthcare team will discuss these different treatments with you and answer all your questions. They will help you choose the best treatment for you, based on your general health, lifestyle, and treatment preference. Your decision does not need to be final. Many people have used each one of these treatments at different times in their lifetime. If I have kidney failure and diabetes, what will my treatment involve? A kidney doctor (called a nephrologist) will plan your treatment with you, your family, and your dietitian. In addition to dialysis or a transplant, you will need to: Keep your blood sugar under control. This is usually done with d Continue reading >>

Diabetic Ketoacidosis

Diabetic Ketoacidosis

Patient professional reference Professional Reference articles are written by UK doctors and are based on research evidence, UK and European Guidelines. They are designed for health professionals to use. You may find the Pre-diabetes (Impaired Glucose Tolerance) article more useful, or one of our other health articles. See also the separate Childhood Ketoacidosis article. Diabetic ketoacidosis (DKA) is a medical emergency with a significant morbidity and mortality. It should be diagnosed promptly and managed intensively. DKA is characterised by hyperglycaemia, acidosis and ketonaemia:[1] Ketonaemia (3 mmol/L and over), or significant ketonuria (more than 2+ on standard urine sticks). Blood glucose over 11 mmol/L or known diabetes mellitus (the degree of hyperglycaemia is not a reliable indicator of DKA and the blood glucose may rarely be normal or only slightly elevated in DKA). Bicarbonate below 15 mmol/L and/or venous pH less than 7.3. However, hyperglycaemia may not always be present and low blood ketone levels (<3 mmol/L) do not always exclude DKA.[2] Epidemiology DKA is normally seen in people with type 1 diabetes. Data from the UK National Diabetes Audit show a crude one-year incidence of 3.6% among people with type 1 diabetes. In the UK nearly 4% of people with type 1 diabetes experience DKA each year. About 6% of cases of DKA occur in adults newly presenting with type 1 diabetes. About 8% of episodes occur in hospital patients who did not primarily present with DKA.[2] However, DKA may also occur in people with type 2 diabetes, although people with type 2 diabetes are much more likely to have a hyperosmolar hyperglycaemic state. Ketosis-prone type 2 diabetes tends to be more common in older, overweight, non-white people with type 2 diabetes, and DKA may be their Continue reading >>

Management Of Hyperglycemia In Diabetic Kidney Disease

Management Of Hyperglycemia In Diabetic Kidney Disease

Role of A1C in DKD A1C has limitations related to its precision and interpretation in the CKD population (4), with erythrocyte turnover being a major cause of A1C imprecision in this population. Red blood cell survival times become shorter as eGFR falls, resulting in a reduction in measured A1C. Treatment with erythrocyte-stimulating agents lowers A1C further, perhaps because of changes in hemoglobin concentrations (5,6). Observational data support the notion that higher A1C levels in nondialysis diabetes patients with CKD stages 3–5 (eGFR levels <60 mL/min/1.73 m2) are associated with worse outcomes, including progression of kidney disease (7). However, these patients are at higher risk for hypoglycemic events (8). Factors that may contribute to this increased risk can include slowed elimination of hypoglycemic agents, alcohol intake, chronic malnutrition, acute caloric deprivation, and decreased renal gluconeogenesis as kidney function declines (8–10). In the ACCORD (Action to Control Cardiovascular Risk in Diabetes) study, when compared with patients with normal renal function, those with baseline serum creatinine of 1.3–1.5 mg/dL had a 66% increased risk of severe hypoglycemia (11). A U-shaped relationship between A1C and mortality has been demonstrated, suggesting that hypoglycemia may be one reason for higher mortality in those with A1C levels <6.5% (7,12,13). Although A1C levels between ∼7 and 8% appear to be associated with the highest survival rates in retrospective studies of DKD patients, the previously highlighted limitations of A1C in the setting of DKD makes A1C goal-setting difficult (8). Despite the inherent limitations of A1C measurement, however, A1C remains a key monitoring parameter in the glycemic management of people with DKD (12). Importan Continue reading >>

Severe Acute Renal Failure In A Patient With Diabetic Ketoacidosis

Severe Acute Renal Failure In A Patient With Diabetic Ketoacidosis

1 King Khalid National Guard Hospital, Jeddah, Kingdom of Saudi Arabia, Department of Pediatrics, Division of Nephrology, Children's Hospital of Eastern Ontario, Ottawa, Canada, Canada 2 Department of Pediatrics, Division of Nephrology, Children's Hospital of Eastern Ontario, Ottawa, Canada Click here for correspondence address and email Acute renal failure (ARF) is a rare but potentially fatal complication of diabetic ketoacidosis (DKA). Early recognition and aggressive treatment of ARF during DKA may improve the prognosis of these patients. We present a case report of a 12 year old female admitted to the hospital with severe DKA as the 1s t manifestation of her diabetes mellitus. She presented with severe metabolic acidosis, hypophosphatemia, and oliguric ARF. In addition, rhabdomyolysis was noted during the course of DKA which probably contributed to the ARF. Management of DKA and renal replacement therapy resulted in quick recovery of renal function. We suggest that early initiation of renal replacement therapy for patients with DKA developing ARF may improve the potentially poor outcome of patients with ARF associated with DKA. How to cite this article: Al-Matrafi J, Vethamuthu J, Feber J. Severe acute renal failure in a patient with diabetic ketoacidosis. Saudi J Kidney Dis Transpl 2009;20:831-4 Diabetic ketoacidosis (DKA) occurs in 10 to 70% of children with type 1 diabetes mellitus (DM1) and has a significant risk of mortality, mostly due to cerebral edema. [1] Other potential complications of DKA include hypokalemia, hypophosphatemia, hypoglycemia, intracerebral and peripheral venous thrombosis, mucormycosis, rhabdomyolysis, acute pancreatitis, acute renal failure (ARF) and sepsis. The development of ARF with rhabdomyolysis is a rare but potentially lethal diso Continue reading >>

Diabetic Ketoacidosis

Diabetic Ketoacidosis

Professor of Pediatric Endocrinology University of Khartoum, Sudan Introduction DKA is a serious acute complications of Diabetes Mellitus. It carries significant risk of death and/or morbidity especially with delayed treatment. The prognosis of DKA is worse in the extremes of age, with a mortality rates of 5-10%. With the new advances of therapy, DKA mortality decreases to > 2%. Before discovery and use of Insulin (1922) the mortality was 100%. Epidemiology DKA is reported in 2-5% of known type 1 diabetic patients in industrialized countries, while it occurs in 35-40% of such patients in Africa. DKA at the time of first diagnosis of diabetes mellitus is reported in only 2-3% in western Europe, but is seen in 95% of diabetic children in Sudan. Similar results were reported from other African countries . Consequences The latter observation is annoying because it implies the following: The late diagnosis of type 1 diabetes in many developing countries particularly in Africa. The late presentation of DKA, which is associated with risk of morbidity & mortality Death of young children with DKA undiagnosed or wrongly diagnosed as malaria or meningitis. Pathophysiology Secondary to insulin deficiency, and the action of counter-regulatory hormones, blood glucose increases leading to hyperglycemia and glucosuria. Glucosuria causes an osmotic diuresis, leading to water & Na loss. In the absence of insulin activity the body fails to utilize glucose as fuel and uses fats instead. This leads to ketosis. Pathophysiology/2 The excess of ketone bodies will cause metabolic acidosis, the later is also aggravated by Lactic acidosis caused by dehydration & poor tissue perfusion. Vomiting due to an ileus, plus increased insensible water losses due to tachypnea will worsen the state of dehydr Continue reading >>

> Hyperglycemia And Diabetic Ketoacidosis

> Hyperglycemia And Diabetic Ketoacidosis

When blood glucose levels (also called blood sugar levels) are too high, it's called hyperglycemia. Glucose is a sugar that comes from foods, and is formed and stored inside the body. It's the main source of energy for the body's cells and is carried to each through the bloodstream. But even though we need glucose for energy, too much glucose in the blood can be unhealthy. Hyperglycemia is the hallmark of diabetes — it happens when the body either can't make insulin (type 1 diabetes) or can't respond to insulin properly (type 2 diabetes). The body needs insulin so glucose in the blood can enter the cells to be used for energy. In people who have developed diabetes, glucose builds up in the blood, resulting in hyperglycemia. If it's not treated, hyperglycemia can cause serious health problems. Too much sugar in the bloodstream for long periods of time can damage the vessels that supply blood to vital organs. And, too much sugar in the bloodstream can cause other types of damage to body tissues, which can increase the risk of heart disease and stroke, kidney disease, vision problems, and nerve problems in people with diabetes. These problems don't usually show up in kids or teens with diabetes who have had the disease for only a few years. However, they can happen in adulthood in some people, particularly if they haven't managed or controlled their diabetes properly. Blood sugar levels are considered high when they're above someone's target range. The diabetes health care team will let you know what your child's target blood sugar levels are, which will vary based on factors like your child's age. A major goal in controlling diabetes is to keep blood sugar levels as close to the desired range as possible. It's a three-way balancing act of: diabetes medicines (such as in Continue reading >>

Invokana Ketoacidosis, Kidney Failure, Kidney Disease, Heart Attack, Stroke, Amputation Lawsuits

Invokana Ketoacidosis, Kidney Failure, Kidney Disease, Heart Attack, Stroke, Amputation Lawsuits

If you or someone you love have suffered side effects such as Diabetic Ketoacidosis, Kidney Disease, Acute/Kidney Failure, Heart Attack, Stroke or Amputation after starting Invokana, Invokamet, Farxiga, Jardiance, Xigduo XR or Glyxambi, you may be eligible for compensation through a defective drug lawsuit against the manufacturer. Our Invokana attorneys are standing by, waiting to assist. Lawsuits allege that Janssen / Johnson & Johnson, manufacturer of Invokana, a popular type two diabetes drug, failed to warn both the medical community and consumers of serious potential side effects including heart attacks, stroke, amputation, kidney failure, kidney disease and diabetic ketoacidosis. Ketoacidosis is a serious condition, usually requiring hospitalization due to the possibility of fatal brain swelling, coma, and severe dehydration. It’s also been alleged that had the public been properly warned, doctors and patients may have chosen something other than Invokana for diabetes management or at the very least, monitored for health issues more frequently. New Lawsuit Accuses Johnson & Johnson, Janssen Pharmaceuticals of Failure to Adequately Research Invokana and Failure to Warn of Health Risks July 13, 2017 – In a lawsuit filed July 3, 2017, plaintiff Martha Williams of Tennessee accuses Janssen Pharmaceuticals and parent company Johnson & Johnson of failure to adequately research all potential health risks of its new generation diabetes drug Invokana as well as failure to warn the public and medical community of such risks. The lawsuit blames an onset of acute renal failure, a urinary tract infection, dehydration and hypokalemia suffered by Williams just one month after starting the medication. “Consumers of Invokana and their physicians relied on the Defendants’ f Continue reading >>

Medications And Kidney Complications, Symptoms Of Diabetic Ketoacidosis

Medications And Kidney Complications, Symptoms Of Diabetic Ketoacidosis

Your kidneys are two organs located on either side of your backbone just above your waist. They remove waste and excess fluid from the blood, maintain the balance of salt and minerals in the blood, and help regulate blood pressure, among other functions. 1 If damaged, they can cause you to have health issues. Acute Renal Injury A sudden loss of kidney function can be caused by: lack of blood flow to the kidneys, direct damage to the kidneys, or blockage of urine from the kidneys. Common causes of these losses of function may include: traumatic injury, dehydration, severe systemic infection (sepsis), damage from drugs/toxins or pregnancy complications. 2 Chronic Kidney Disease When kidney damage and decreased function lasts longer than three months, it is called chronic kidney disease (CKD). CKD can be dangerous, as you may not have any symptoms until after the kidney damage, which may or may not be able to be repaired, has occurred. High blood pressure and diabetes (types 1 and 2) are the most common causes of CKD. 3 Causes of Chronic Kidney Disease There are also other causes of CKD. These can include: Immune system conditions (e.g., lupus) Long-term viral illnesses (HIV/AIDS, hepatitis B, hepatitis C) Pyelonephritis (urinary tract infections within the kidneys) Inflammation in the kidney’s filters (glomeruli) Polycystic kidney disease (fluid-filled cysts form in the kidneys) Congenital defects (malformations present at birth) Toxins, chemicals Type 2 Diabetes Symptoms People with uncontrolled type 2 diabetes have high levels of sugar (glucose) building up and circulating in the blood. This high blood sugar can cause heart disease, stroke, kidney disease, blindness and nerve damage, among other complications. 5 You may have no type 2 diabetes symptoms, or symptoms ma Continue reading >>

More in ketosis